Outcome of group B streptococcal prosthetic hip infections compared to that of other bacterial infections

Outcome of group B streptococcal prosthetic hip infections compared to that of other bacterial infections
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DOI:
10.1016/j.jbspin.2008.11.010
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发表时间:
2009-10-01
期刊:
影响因子:
4.2
通讯作者:
Desplaces, Nicole
Desplaces, Nicole
中科院分区:
医学2区
文献类型:
--
作者:
Zeller, Valerie;Lavigne, Marina;Desplaces, Nicole

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背景:链球菌性人工髋关节感染的预后通常被认为比其他病原体引起的好。这一假设并没有得到证实,在我们的经验与组B链球菌假体joint infection.Objective:我们比较了组B链球菌和其他病原体假体hip infection.Methods:139例患者,24组B链球菌和115其他病原体假体hip感染,包括。主要结局是从手术治疗到治疗失败的时间,治疗失败定义为复发、感染或治疗相关死亡。次要结局是从手术治疗到复发或任何事件(无事件生存期)的时间。使用累积发生率估计量对主要和次要结局进行建模。多变量回归分析被用来确定一组独立的预测因素治疗failure.Results:随访中位数为22个月,治疗失败更频繁的患者组B链球菌假体髋关节感染(风险比,4.88 [95%CI,1.4-17],P = 0.012)。多变量分析保留了美国麻醉医师协会评分和B组链球菌感染作为治疗失败的独立危险因素;这些患者的无事件生存率较低(风险比,2.64 [95%CI,1.2-6],P = .02)。结论:尽管抗生素敏感性高,但B组链球菌和其他病原体假体髋关节感染的结局不同。(C)2009年法国Rhumatologie协会。由Elsevier Masson SAS出版。All rights reserved.
Background: Outcome of streptococcal prosthetic hip infection is often thought to be better than that caused by other pathogens. That supposition was not confirmed in our experience with group B streptococcal prosthetic joint infection.Objective: We compared outcomes of group B streptococcal and other-pathogen prosthetic hip infections.Methods: One hundred and thirty nine patients, 24 with group B streptococcal and 115 other-pathogen prosthetic hip infections, were included. The primary outcome was the time from surgical treatment to treatment failure, defined as relapse, infection-or treatment-related death. Secondary outcomes were the times from surgical treatment to relapse or any event (event-free survival). The cumulative incidence estimator was used to model primary and secondary outcomes. Multivariable regression analysis was used to determine a set of independent predictors of treatment failure.Results: With a median follow-up of 22 months, treatment failed more frequently in patients with group B streptococcal prosthetic hip infections (hazard ratio, 4.88 [95% CI, 1.4-17], P = .012). Multivariable analysis retained the American Society of Anesthesiologist score and group B streptococcal infection as independent risk factors of treatment failure; event-free survival was lower for these patients (hazard ratio, 2.64 [95% CI, 1.2-6], P = .02).Conclusion: Despite high antibiotic susceptibility, outcomes of group B streptococcal and other-pathogen prosthetic hip infection differ. (C) 2009 Societe Francaise de Rhumatologie. Published by Elsevier Masson SAS. All rights reserved.